Document Detail


Cardiac herniation following completion pneumonectomy for bronchiectasis.
MedLine Citation:
PMID:  20826968     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sporadic reports on cardiac herniation are available in the literature; most of them had followed intrapericardial pneumonectomies for malignant pulmonary tumors. We present an uncommon event of heart herniation after a completion pneumonectomy indicated for chronic bronchiectasis. A 35-year-old male patient was operated for left completion pneumonectomy. A 6 cm x 4 cm area of adherent pericardium near the obtuse margin of heart was removed during surgery. During head-end elevation of the bed in postoperative intensive care unit, patient got accidentally tilted to the left side, which resulted in ventricular fibrillation. Chest cavity was re-opened for cardiopulmonary resuscitation. Left ventricle was found herniating through the pericardial deficiency into the left-thoracic cavity with the cardiac apex touching chest wall. During surgical re-exploration, the pericardial deficiency was closed with a synthetic Dacron patch. Hemodynamic condition remained stable in the immediate postoperative period. Patients had infection of the left thoracic cavity after 5 weeks, for which he was subjected to thoracoplasty and omentopexy. Prompt recognition with timely intervention is life saving from cardiac herniation. Strategy of closing the pericardial defect after pneumonectomy should be followed routinely, irrespective of the indication for pneumonectomy.
Authors:
Shrinivas Gadhinglajkar; Shivananda Siddappa; Rupa Sreedhar; Unnikrishnan Madathipat
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of cardiac anaesthesia     Volume:  13     ISSN:  0974-5181     ISO Abbreviation:  Ann Card Anaesth     Publication Date:    2010 Sep-Dec
Date Detail:
Created Date:  2010-09-09     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815987     Medline TA:  Ann Card Anaesth     Country:  India    
Other Details:
Languages:  eng     Pagination:  249-52     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India. shri@sctimst.ac.in
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MeSH Terms
Descriptor/Qualifier:
Adult
Bronchiectasis / surgery*
Heart Diseases / etiology,  surgery*
Hernia / etiology,  surgery*
Humans
Male
Pericardium / pathology
Pneumonectomy / adverse effects*
Postoperative Complications / diagnosis,  surgery*
Reoperation
Surgical Wound Infection / complications
Ventricular Fibrillation / etiology,  physiopathology,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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